Treatment of Severe Hypercalcemia

The normal calcium level in the body is between 2.2–2.6 mmol/L. The calcium levels are regulated by a hormone known as the parathyroid hormone (PTH) which is secreted by the parathyroid gland. If the body fails to maintain the calcium levels within the normal ranges, hypercalcemia or hypocalcemia results. This article focuses on hypercalcemia. Read on to learn about the causes, symptoms, diagnosis and management of hypercalcemia.

00:01
Severe hyp-hypercalcemia, what do you want
to do?Remember, with the severe hypercalcemia, there’s
quite a bit of calcium that’s being filteredinto the urine.
00:09
Thus may result in osmotic diuresis and kind
of like what we talked about earlier withuncontrolled diabetes haemolytis.
00:15
What’s one of the first steps that you’re
doing?Replenish, replenish, replenish the fluid.
00:21
Mobilization, if possible.
00:24
Remember, that mobilization, lightweight to
a certain extent, may then also help withsevere hypercalcemia.
00:34
Bisphosphonates allows for proper mineralization
of the bone to remove the calcium out of thecirculation, inhibit resorption.
00:43
Effect begins within two days, maximum at
a week for bisphosphonates.
00:48
Calcitonin, technically, at this point, it
may inhibit bone resorption.
00:55
That’s all that I wish to say about this,
but in pathology, please make sure that youkeep in mind with calcitonin, parafollicular
C cells and use as a marker with medullarycancer of the thyroid.
01:09
Glucocorticoids, effective in Vitamin D-mediated
hypercalcemia.
01:13
So, for example, your patient, African-American
lady, young, maybe in her early 40’s andshe has hypertension and upon chest X-ray,
you find these granulomas.
01:26
In addition to that, you find hypercalcemia
and glucocorticoids seem to be quite effectivein those patients who has sarcoidosis.
01:33
It inhibits the conversion or inhibits calcitriol
production in general.

About the Lecture

The lecture Treatment of Severe Hypercalcemia by Carlo Raj, MD is from the course Parathyroid Gland Disorders.

Included Quiz Questions

Bisphosphonates are an important part of management of a patient with hypercalcemia. Why should this not be your primary treatment in a patient with acute hypercalcemia?

The effect takes days to begin

It increases osmotic diuresis

It can lead to thromboembolism

It decreases calcium too quickly in a hypercalcemic patient

It inhibits resorption of bone

What is the most effective treatment for hypercalcemia for a patient with sarcoidosis?

Glucocorticoids

Calcitonin

Bisphosphonates

IV fluids

Vitamin D

Author of lecture Treatment of Severe Hypercalcemia

Carlo Raj, MD

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